Gaietà Permanyer-Miralda

Agency for Healthcare Quality and Evaluation of Catalonia, Barcino, Catalonia, Spain

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Publications (150)1194.29 Total impact

  • Maite Solans-Domènech · Gaietà Permanyer-Miralda

    No preview · Article · Jan 2016
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    ABSTRACT: The objective of the OFRECE study was to estimate the prevalence of stable angina in Spain. This prevalence is currently unknown, due to a lack of recent studies and to changes in the epidemiology and treatment of ischemic heart disease. This cross-sectional study involved a representative sample of the Spanish population aged 40 years or older, obtained via 2-stage random sampling: in the first stage, primary care physicians were randomly selected from each Spanish province, whereas in the second stage 20 people were selected from the population assigned to each physician. The prevalence was weighted by age, sex, and geographical area. Participants were classified as having angina if they met the "definite angina" criteria of the Rose questionnaire and as having confirmed angina if the angina was confirmed by a cardiologist or if they had a history of acute ischemic heart disease or revascularization. Of the 11 831 people invited to participate, 8378 (71%) were analyzed (mean age, 59.2 years). The weighted prevalence of definite angina (Rose) was 2.6% (95% confidence interval, 2.1%-3.1%) and was higher in women (2.9%) than in men (2.2%), whereas that of confirmed angina was 1.4% (95% confidence interval, 1.0%-1.8%), without differences between men (1.5%) and women (1.3%). The prevalence of definite angina (Rose) increased with age (0.7% in patients aged 40 to 49 years and 7.1% in those aged 70 years or older), history of cardiovascular disease, and cardiovascular risk factors, except smoking. The prevalence of definite angina (Rose) in the Spanish population aged 40 years or older was 2.6%, whereas that of confirmed angina was 1.4%. Both prevalences increased with age, cardiovascular risk factors, and cardiovascular history. Copyright © 2014 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.
    Full-text · Article · Feb 2015 · Revista Espanola de Cardiologia
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    ABSTRACT: The objective of the OFRECE study was to estimate the prevalence of stable angina in Spain. This prevalence is currently unknown, due to a lack of recent studies and to changes in the epidemiology and treatment of ischemic heart disease.
    No preview · Article · Feb 2015 · Revista Espa de Cardiologia
  • Joan M.V. Pons · Gaietà Permanyer-Miralda · Jordi Camí · Joan Rodés

    No preview · Article · Nov 2014 · Medicina Clínica
  • Joan M V Pons · Gaietà Permanyer-Miralda · Jordi Camí · Joan Rodés

    No preview · Article · May 2014
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    Gaietà Permanyer-Miralda · Maite Solans-Domènech · Joan M V Pons · Imma Guillamón · Paula Adam

    Full-text · Dataset · Oct 2013
  • Gaietà Permanyer-Miralda · Paula Adam · Imma Guillamón · Maite Solans-Domènech · Joan M.V. Pons
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    ABSTRACT: Introduction The study aims to illustrate the impact of Spanish research in clinical decision making. To this end, we analysed the characteristics of the most significant Spanish publications cited in clinical practice guidelines (CPG) on mental health. Material and methods We conducted a descriptive qualitative study on the characteristics of ten articles cited in Spanish CPG on mental health, and selected for their “scientific quality”. We analysed the content of the articles on the basis of the following characteristics: topics, study design, research centres, scientific and practical relevance, type of funding, and area or influence of the reference to the content of the guidelines. Results Among the noteworthy studies, some basic science studies, which have examined the establishment of genetic associations in the pathogenesis of mental illness are included, and others on the effectiveness of educational interventions. The content of those latter had more influence on the GPC, because they were cited in the summary of the scientific evidence or in the recommendations. Some of the outstanding features in the selected articles are the sophisticated designs (experimental or analytical), and the number of study centres, especially in international collaborations. Debate or refutation of previous findings on controversial issues may have also contributed to the extensive citation of work. Conclusions The inclusion of studies in the CPG is not a sufficient condition of “quality”, but their description can be instructive for the design of future research or publications.
    No preview · Article · Oct 2013 · Revista de Psiquiatría Biológica y Salud Mental
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    ABSTRACT: Background This article reports on the impact assessment experience of a funding program of non-commercial clinical and health services research. The aim was to assess the level of implementation of results from a subgroup of research projects (on respiratory diseases), and to detect barriers (or facilitators) in the translation of new knowledge to informed decision-making. Methods A qualitative study was performed. The sample consisted of six projects on respiratory diseases funded by the Agency for Health Quality and Assessment of Catalonia between 1996 and 2004. Semi-structured interviews to key informants including researchers and healthcare decision-makers were carried out. Interviews were recorded, transcribed verbatim and analysed on an individual (key informant) and group (project) basis. In addition, the differences between achieved and expected impacts were described. Results Twenty-three semi-structured interviews were conducted. Most participants indicated changes in health services or clinical practice had resulted from research. The channels used to transfer new knowledge were mainly conventional ones, but also in less explicit ways, such as with the involvement of local scientific societies, or via debates and discussions with colleagues and local leaders. The barriers and facilitators identified were mostly organizational (in research management, and clinical and healthcare practice), although there were also some related to the nature of the research as well as personal factors. Both the expected and achieved impacts enabled the identification of the gaps between what is expected and what is truly achieved. Conclusions In this study and according to key informants, the impact of these research projects on decision-making can be direct (the application of a finding or innovation) or indirect, contributing to a more complex change in clinical practice and healthcare organization, both having other contextual factors. The channels used to transfer this new knowledge to clinical practice are complex. Local scientific societies and the relationships between researchers and decision-makers can play a very important role. Specifically, the relationships between managers and research teams and the mutual knowledge of their activity have shown to be effective in applying research funding to practice and decision-making. Finally the facilitating factors and barriers identified by the respondents are closely related to the idiosyncrasy of the human relations between the different stakeholders involved.
    Full-text · Article · May 2013 · Health Research Policy and Systems
  • Gaietà Permanyer-Miralda · Paula Adam · Imma Guillamón · Maite Solans-Domènech · Joan M V Pons
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    ABSTRACT: Introduction: The study aims to illustrate the impact of Spanish research in clinical decision making. To this end, we analysed the characteristics of the most significant Spanish publications cited in clinical practice guidelines (CPG) on mental health. Material and methods: We conducted a descriptive qualitative study on the characteristics of ten articles cited in Spanish CPG on mental health, and selected for their "scientific quality". We analysed the content of the articles on the basis of the following characteristics: topics, study design, research centres, scientific and practical relevance, type of funding, and area or influence of the reference to the content of the guidelines. Results: Among the noteworthy studies, some basic science studies, which have examined the establishment of genetic associations in the pathogenesis of mental illness are included, and others on the effectiveness of educational interventions. The content of those latter had more influence on the GPC, because they were cited in the summary of the scientific evidence or in the recommendations. Some of the outstanding features in the selected articles are the sophisticated designs (experimental or analytical), and the number of study centres, especially in international collaborations. Debate or refutation of previous findings on controversial issues may have also contributed to the extensive citation of work. Conclusions: The inclusion of studies in the CPG is not a sufficient condition of "quality", but their description can be instructive for the design of future research or publications.
    No preview · Article · Feb 2013
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    ABSTRACT: Introducción y objetivos La fibrilación auricular se asocia con elevadas morbilidad y mortalidad, y tanto su incidencia como su prevalencia son altas. No obstante, hay escasos datos poblacionales sobre su epidemiología en España. El objetivo de este estudio es estimar la prevalencia de fibrilación auricular en España. Métodos Estudio transversal en población española de 40 o más años. Se realizó un muestreo en dos etapas, una primera selección aleatoria de médicos de atención primaria de cada provincia española y, en segundo lugar, se seleccionó aleatoriamente a 20 individuos de la población asignada a cada médico participante. La prevalencia se ponderó por edad, sexo y área geográfica. Se realizó una lectura centralizada de los registros electrocardiográficos. Resultados Se evaluó a 8.343 personas (media de edad, 59,2 [intervalo de confianza del 95%, 58,6-59,8] años; el 52,4% mujeres). La prevalencia total de fibrilación auricular fue del 4,4% (intervalo de confianza del 95%, 3,8-5,1). La prevalencia fue similar en varones (4,4% [3,6-5,2]) y mujeres (4,5% [3,6-5,3]) y se incrementa progresivamente a partir de los 60 años de edad. En los mayores de 80 años, la prevalencia fue del 17,7% (14,1-21,3). En un 10% de pacientes se diagnosticó una fibrilación auricular no conocida. Conclusiones La prevalencia de fibrilación auricular en la población general española mayor de 40 años es elevada, del 4,4%. La prevalencia es similar en varones y mujeres y se incrementa escalonadamente a partir de los 60 años. Se estima en más de 1 millón de pacientes con fibrilación auricular en la población española, de los que más de 90.000 están sin diagnosticar.
    Full-text · Article · Jan 2013 · Revista Espa de Cardiologia
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    ABSTRACT: Introduction and objectives Atrial fibrillation is associated with substantial morbidity and mortality and both its incidence and prevalence are high. Nevertheless, comprehensive data on this condition in Spain are lacking. The aim of this study was to estimate the prevalence of atrial fibrillation in Spain. Methods A cross-sectional study was conducted in the general Spanish population older than 40 years. Two-stage random sampling was used, in which first-stage units were primary care physicians randomly selected in every Spanish province and second-stage units were 20 randomly selected persons drawn from each participating physician's assigned population. The reported prevalence was standardized for the age and sex distribution of the Spanish population. The electrocardiogram recordings were read centrally. Results Overall, 8343 individuals were evaluated. The mean age was 59.2 years (95% confidence interval, 58.6-59.8 years), and 52.4% of the participants were female. The overall age-adjusted prevalence of atrial fibrillation was 4.4% (95% confidence interval, 3.8-5.1). Prevalence was similar in both sexes, men 4.4% (3.6-5.2) and women 4.5% (3.6-5.3), rising with increasing age older than 60 years. In patients older than 80 years, the prevalence was 17.7% (14.1-21.3). In 10% of patients an unknown atrial fibrillation was diagnosed. Conclusions The prevalence of atrial fibrillation in the general Spanish population older than 40 years is high, at 4.4%. The prevalence is similar in both sexes and rises steeply above 60 years of age. It is estimated that there are over 1 million patients with atrial fibrillation in the Spanish population, of whom over 90 000 are undiagnosed. Full English text available from:www.revespcardiol.org/en
    Full-text · Article · Jan 2013 · Revista Espa de Cardiologia
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    Adam P · Solans-Domènech M · Pons JMV · Aymerich M · Berra S · Guillamon I · Sánchez E · Permanyer-Miralda G
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    ABSTRACT: This article presents the ex-post assessment of a program of clinical and health services research and the evaluation of the social impact. The Catalan Agency for Health Information, Assessment, and Quality (CAHIAQ) promotes a biannual open, public, competitive extramural research call to conduct non-commercial clinical and health services research. Its aim is to address local needs of research (knowledge gaps) and to assess the implementation of innovation. Approximately 5.8 million Euros have been allocated to the call. To meet the Agency's mission, a periodical 'call for expressions of interest' and topic prioritization is organized prior to the research call. The awarded projects are submitted to an ex-ante, ongoing, and ex-post assessment. Impact assessment of the research call on advancing knowledge and healthcare decision making is based on the Canadian Academy of Health Sciences framework (Panel on Return on Investment in Health Research, 2009). The methods used include bibliometric analysis, surveys to researchers and decision-makers, and a more in-depth case study of translation pathways. This includes a crossover of cases from 1996 to 2004. Some results are compared against other international health services research calls. The conclusion is that local agencies can significantly contribute to fill knowledge gaps in a specific context. Assessment of the complete research cycle provides opportunities for improving the entire research process (identification of knowledge needs, call for proposals, funding allocation, research completion, subsequent impact). Specifically, assessment of the different types of impact of research development on knowledge generation and decision making closes the evaluation cycle fulfilling the Agency's mission. © 2012 The Author. Published by Oxford University Press. All rights reserved.
    Full-text · Article · Oct 2012 · Research Evaluation
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    ABSTRACT: Objectives The goal of this study was to assess the risk associated with double antiplatelet therapy (DAT) discontinuation, and specifically, temporary discontinuation, during the first year after drug-eluting stent (DES) implantation. Background Doubts remain about the risk of temporary DAT discontinuation within 1 year after DES implantation. Methods A total of 1,622 consecutive patients undergoing DES implantation at 29 hospitals were followed up at 3, 6, 9, and 12 months to record the 1-year antiplatelet therapy discontinuation (ATD) rate, the number of days without DAT, and the rate of 1-year major cardiac events. Cox regression was used to analyze the association between ATD considered as a time-dependent covariate and 1-year cardiac events. Results One hundred seventy-two (10.6%) patients interrupted at least 1 antiplatelet drug during the first year after DES implantation, although only 1 during the first month. Most (n = 111, 64.5%) interrupted DAT temporarily (median: 7 days; range: 5 to 8.5): 79 clopidogrel (31 temporarily), 38 aspirin (27 temporarily), and 55 both drugs (53 temporarily). Discontinuation was followed by acute coronary syndrome in 7 (4.1%; 95% confidence interval [CI]: 1.7 to 8.2), a similar rate of major cardiac events to that in patients without ATD (n = 80; 5.5%; 95% CI: 4.4 to 6.8; p = 0.23). ATD was not independently associated with 1-year major cardiac events (hazard ratio: 1.32 [95% CI: 0.56 to 3.12]). Conclusions ATD within the first year and beyond the first month after DES is not exceptional, is usually temporary, and does not appear to have a large impact on risk.
    Full-text · Article · Oct 2012 · Journal of the American College of Cardiology
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    ABSTRACT: Aims: To determine the prevalence of aortic valve sclerosis (ASC) and stenosis (AS) in the elderly in a Mediterranean area and to identify associated clinical factors. Methods and results: Population cross-sectional study in a random sample of 1068 people ≥65 years in a Mediterranean area. ASC was categorized as absent, mild-to-moderate, or moderate-to-severe depending on the severity of thickening and calcification. The relation between the severity of ASC and potential risk factors was assessed by multinomial logistic regression analysis. Some degree of thickening and/or calcification was present in 45.4%, of the sample, 73.5% in >85 years. AS prevalence was 3% for the total cohort and 7.4% in >85 years. Adjusting for gender it was found that age, smoking habit, hypertension, waist circumference, and ankle-brachial index <0.9 were associated with degrees of ASC. Except for waist circumference, there was a gradient between the magnitude of association and the severity of ASC. The OR for age was 1.56 (95% CI 1.39-1.76) for mild-to-moderate ASC and 2.03 (95% CI 1.72-2.4) for moderate-to-severe ASC, and for smoking habit 1.59 (95% CI 1.08-2.34) for mild-to-moderate ASC and 2.13 (95% CI 1.19-3.78) for moderate-to-severe ASC. Diabetes and renal impairment were associated with advanced but not with early stages of ASC. Conclusions: The prevalence of ASC and AS in people ≥65 years is similar to that reported in other regions. The gradient in the association of cardiovascular risk factors with the severity of ASC suggests that they may be causally implied in the pathogenesis of the disease.
    Full-text · Article · Jun 2012
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    ABSTRACT: Patent false lumen in aortic dissection has been associated with poor prognosis. We aimed to assess the natural evolution of this condition and predictive factors. One hundred eighty-four consecutive patients, 108 surgically treated type A and 76 medically treated type B, were discharged after an acute aortic dissection with patent false lumen. Transesophageal echocardiography was performed before discharge, and computed tomography was performed at 3 months and yearly thereafter. Median follow-up was 6.42 years (quartile 1 to quartile 3: 3.31-10.49). Forty-nine patients died during follow-up (22 type A, 27 type B), 31 suddenly. Surgical or endovascular treatment was indicated in 10 type A and 25 type B cases. Survival free from sudden death and surgical-endovascular treatment was 0.90, 0.81, and 0.46 (95% CI, 0.36-0.55) at 3, 5, and 10 years, respectively. Multivariate analysis identified baseline maximum descending aorta diameter (hazard ratio [HR]: 1.32 [1.10-1.59]; P=0.003), proximal location (HR: 1.84 [1.06-3.19]; P=0.03), and entry tear size (HR: 1.13 [1.08-1.2]; P<0.001) as predictors of dissection-related adverse events, whereas mortality was predicted by baseline maximum descending aorta diameter (HR: 1.36 [1.08-1.70]; P=0.008), entry tear size (HR: 1.1 [1.04-1.16]; P=0.001), and Marfan syndrome (HR: 3.66 [1.65-8.13]; P=0.001). Aortic dissection with persistent patent false lumen carries a high risk of complications. In addition to Marfan syndrome and aorta diameter, a large entry tear located in the proximal part of the dissection identifies a high-risk subgroup of patients who may benefit from earlier and more aggressive therapy.
    Preview · Article · May 2012 · Circulation
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    Sònia Abilleira · Aida Ribera · Gaietà Permanyer-Miralda · Ricard Tresserras · Miquel Gallofré
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    ABSTRACT: To investigate the 30-day and 12-month mortality risks among hospitalized stroke patients according to compliance with guideline-based process indicators. We used data from the Second Stroke Audit and the Mortality Register of Catalonia (Spain). The audit retrospectively explored quality of stroke care based on compliance with indicators among patients discharged from all public hospitals in Catalonia in 2007; they were identified and selected through a pre-established sampling method. The magnitude of the independent association of each indicator with 30-day and 12-month mortality was assessed using logistic regression with generalized estimating equations to account for clustering of patients within hospitals. Generalized estimating equations modeling was initially restricted to patients alive >72 hours poststroke to control for confounding by severity. Analyses were also run in 3 other samples (all patients, patients alive >7 days, and patients alive >14 days). Of 1767 stroke admissions in the Second Stroke Audit, 1697 patients survived >72 hours poststroke. Within this sample, the adjusted 30-day mortality risk was negatively associated with nonadherence to different indicators, of which only antithrombotics at discharge (OR, 4.3; 95% CI, 1.72-10.78) remained significant in all data sets. At 12 months, the adjusted mortality risk was negatively associated with management of hypertension (OR, 1.87; 95% CI, 1.22-2.86) and antithrombotics at discharge (OR, 2.79; 95% CI, 1.41-5.54). Both remained unchanged across different samples. Assessing the impact of quality of stroke care on mortality is complex and is hampered by residual confounding, particularly in the short-term. Nevertheless, this study suggests that at least a few indicators should be used to monitor quality of stroke services.
    Preview · Article · Mar 2012 · Stroke
  • Guillamón I · Solans-Domènech M · Permanyer-Miralda G · Adam P

    No preview · Article · Jan 2012
  • P Adam · M Solans-Domènech · J.M.V Pons · M Aymerich · S Berra · I Guillamón · E Sánchez · G Permanyer-Miralda

    No preview · Article · Jan 2012
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    ABSTRACT: Introduction and objectivesTo determine whether mortality from acute myocardial infarction has reduced in Spain and the possibly related therapeutic factors.
    No preview · Article · Nov 2011 · Revista Espa de Cardiologia
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    ABSTRACT: Advanced atherosclerotic disease increases the risk of stent thrombosis after drug-eluting stent (DES) implantation. We aimed to determine if an abnormal ankle-brachial index (ABI) value as a surrogate of atherosclerotic disease and vascular inflammation provides information on 1-year risk of cardiovascular events after DES implantation. A prospective cohort of 1,437 consecutive patients undergoing DES implantation from January through April 2008 in 26 Spanish hospitals was examined. ABI was calculated by Doppler in a standardized manner. Patients were followed to 12 months after the percutaneous coronary intervention to determine total and cardiovascular mortality, stroke, nonfatal acute coronary syndrome (ACS), and new revascularizations. Association of an abnormal ABI value (i.e., ≤ 0.9 or ≥ 1.4) with outcomes was assessed by conventional logistic regression and by propensity-score analysis. Patients with abnormal ABI values (n = 582, 40.5%) in general had higher global cardiovascular risk, the reason for DES implantation was more often ACS, and had a higher rate of complications during admission (heart failure or stroke or major hemorrhage 11.3% vs 5.3%, p <0.001). An abnormal ABI value was independently associated with 1-year total mortality (odds ratio 2.23, 95% confidence interval 1.13 to 4.4) and cardiovascular mortality (odds ratio 2.06, 95% confidence interval 1.04 to 4.22). No independent association was found between an abnormal ABI value and 1-year nonfatal ACS, stroke, and new revascularizations. In conclusion, although an abnormal ABI value was associated with fatal outcomes in patients receiving DESs, no association was found with nonfatal ACS and new revascularizations. A clear relation between abnormal ABI and surrogates of DES thrombosis could not be established.
    No preview · Article · Aug 2011 · The American journal of cardiology

Publication Stats

5k Citations
1,194.29 Total Impact Points

Institutions

  • 2013-2016
    • Agency for Healthcare Quality and Evaluation of Catalonia
      Barcino, Catalonia, Spain
  • 1988-2015
    • University Hospital Vall d'Hebron
      • • Department of Cardiology
      • • Departamento de Medicina
      Barcino, Catalonia, Spain
  • 2010-2012
    • Hospital Valle Del Nalon
      Rianxo, Galicia, Spain
    • Autonomous University of Barcelona
      Cerdanyola del Vallès, Catalonia, Spain
  • 2009-2010
    • Vall d’Hebron Institute of Oncology
      Barcino, Catalonia, Spain
    • Mapi Values
      Lyons, Rhône-Alpes, France
  • 1995-2009
    • Institut Marqués, Spain, Barcelona
      Barcino, Catalonia, Spain
  • 1999
    • Hospital Universitari Joan XXIII de Tarragona
      Tarraco, Catalonia, Spain